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PubMedDate not supplied

The changing face of Canadian home parenteral therapy.

This article describes the Calgary Health Region Home Parenteral Therapy Program (HPTP), which has successfully shifted infusion therapies such as anti-infectives, analgesics, hydration, vasodilators, glucocorticoids, and iron-chelating agents from the hospital to patients' homes. Particular attention is given to the parenteral administration of anti-infectives, which currently accounts for more than 95% of program adult therapy days.

Adult↗
PubMed2003

Terrorism: a public health threat with a trauma system response.

BACKGROUND: The threat of mass casualties and widespread infectious disease caused by terrorism is now a challenge for our government and public health system. Funds have been granted to the states by the Centers for Disease Control and Prevention and the Health Resources and Services Administration to establish bioterrorism preparedness and response capabilities. METHODS: Hartford Hospital has been designated as a Center of Excellence for Bioterrorism Preparedness by the Commissioner of the Connecticut Department of Public Health. The Center of Excellence has implemented strategies to prepare for a possible bioterrorist attack. A unique model that combines epidemiology and traumatology is being used to guide the preparedness activities. Although the focus of the grant from the Connecticut Department of Public Health is bioterrorism, the application of the model can apply to preparation for all terrorist events. RESULTS: Implementation of strategies indicates that bioterrorism preparedness is well underway. Similar initiatives should be achievable by other trauma systems throughout the country. CONCLUSION: A Center of Excellence for Bioterrorism Preparedness in Connecticut is successfully modifying a trauma system to meet the challenge of a new public health threat, terrorism.

Centers for Disease Control and Prevention, U.S.↗
PubMed1997

Managed care merged with the German model.

The cutbacks in Medicare and Medicaid reimbursement, and the Republican takeover of Capitol Hill and the state legislatures as a result of recent elections, suggest that the payer-driven forces of managed care, capitated payment, and the regional networks (alliances) will serve as centerpieces to improve the organization, financing, and delivery of America's health services. These "voluntary" alliances that are now being forged as an amalgam of health providers and insurance underwriters, often foreshadow the powerful, geographically linked regional health networks that are evolving into oligopolies throughout the United States. As the Department of Justice and the Federal Trade Commission are unable to appropriately analyze the efficacy of most prospective mergers, the American health field increasingly can expect monopolistic environments. In this process, the public eventually may demand the formation of state health services commissions. Within this framework, the German decentralized, multipayer, multitier approach, which historically is self-governing and allows for negotiating reimbursement rates between insurers and providers, offers a preferred option to the traditional American public utility model.

Antitrust Laws↗
PubMed2003

Providers' perceptions of how rural consumers access and use mental health services.

This article describes the third phase of a research study undertaken within a Canadian provincial regional health authority to explore and analyze mental health services and other resources used by rural consumers after discharge from inpatient mental health programs. The focus of this article is the qualitative research findings obtained from mental health service providers and members of allied agencies. This article will discuss the literature on rural consumers' access and use of mental health programs and services; describe the context and method used to conduct the focus groups with rural service providers; characterize access and use problems from the service providers' perspectives; and suggest strategies to address these problems.

Attitude of Health Personnel↗
PubMedDate not supplied

How a heart network can influence a cardiovascular product line.

The authors believe that a viable heart network program can give tertiary centers the competitive edge in cardiology marketing, can provide the opportunity to fine-tune cardiovascular product lines and can position hospitals to meet the challenges of the next decade in healthcare. However, success will be determined by an institution's ability to carefully balance cost and quality issues.

Alabama↗
PubMed2005

Fraser Health PACS project: learning from experience in planning.

Fraser Health is proud of its new imaging technology. Making the transition from film to PACS has proven to be both rewarding and challenging. PACS is now performing as planned, providing physicians and health care providers with a faster, safer, more streamlined imaging service than ever before. Most importantly, PACS works. The challenge of transition and learning a complex new technology that is proving to be effective is worth the effort. Physicians and healthcare providers within the filmless sites say they would not go back to film. Although PACs will return untold dividends for patients and care providers through timely sharing and analysis of images, Fraser Health's PACs project team has learned a number of valuable and transferable lessons about managing a project of this scope and complexity.

British Columbia↗
PubMedDate not supplied

Regionalization of infant transports: the southern California experience and its implications. I: Referral pattern.

The development and implementation of neonatal intensive care services have been essential components of perinatal regionalization during the past two decades. The transport of critically ill infants to regional neonatal intensive care units has played an important role in improving neonatal outcome. This article presents a profile of Southern California's 10-year infant transport experience (1979 through 1988) in terms of the following indicators: transport volume, cross-county referrals, distance travelled, referral pattern, and birth weight pattern. Findings point to the necessity of focusing attention on several critical issues confronting Southern California's neonatal services in the 1990s. They include adequacy of tertiary or intermediate bed capacity in neonatal intensive care units; appropriateness of existing infant referral practices; impact of maternal-fetal transports; availability of financing resources; and overall differences in morbidity and mortality rates between transported and nontransported infants in subpopulations.

Birth Weight↗
PubMed2004

Putting E-government to work in healthcare environment: a multiregional project funded by the Italian Innovation & Technology Ministry.

In 2002, the Italian Ministry of Innovation promoted a national bid for e-government projects. Specifically it allocated a budget of 120 M euro. One of the four project approved in healthcare sector was the "Information, Care ("Assistenza" in Italian) and healthcare Education by the Web" (IAEW), with a global budget of 2580 k euro, partially financed by Ministry with a quota of 830 k euro. The project involves 12 medical structures (both national excellences centers and local regional hospitals) located in two different Region of North Italy, dealing with two different healthcare regional systems (Lombardia and Emilia-Romagna), with potentially 3 millions of users.

Computer Systems↗
PubMed1999

Integration of quality programs by telemedicine in surgical services.

Surgical procedures can be performed and monitored in operating rooms physically isolated, but electronically linked to a parent medical center, and certainly from distant consultation. Quality of surgical care has been measured in retrospect rather than in real time, and outcomes have generally not had the benefit of immediate consultation and group analysis. However, telemedicine can connect consultants, surgeons, patients, and databases. The Yale Telemedicine Center has developed network schemes, which connect the OR of trainees with the laboratory of the teacher, and has opened a continuum between pedagogy and product. The program has connected regional hospitals, connected components of hospital systems, and has been used in international testbeds. The particular operative procedures studied have been laparoscopic procedures. The consultant is based at Yale and is connected with the distant OR to share the laparoscopic surgical field. Connection includes real time video, audio and the ability to draw instruction on the OR screen. Bandwidths as low as 12kbs(POTS) have been employed with modification with effective intervention. The potential for quality improvement is substantial, and inclusion in quality programs is strongly recommended.

Connecticut↗
PubMed1976

Evaluating student performance in a decentralized basic science program.

The results of the evaluation of the basic science curriculum in a regionalized medical education program in the states of Washington, Alaska, Montana, and Idaho (WAMI) are presented and discussed. The hypothesis that students taking the first quarter of basic science at universities remote from the Unversity of Washington School of Medicine (UWSM) will be no different in academic performance from those who remain at the UWSM is tested. The variables considered were student performance on (a) common tests in Anatomy/Histology, Biochemistry, Mechanisms of Physiology, and Epidemiology; (b) subsequent course work at the UWSM; and (c) the mini-tests and Part I of the examinations of the National Board of Medical Examiners. The developement of the common tests is described. Analysis of variance indicates that the null hypothesis cannot be rejected at the .05 level.

Alaska↗